Prison Health Discharge Planning- Evidence of an integrated care pathway or the end of the road?

This article is based on research conducted in several prisons in North East England. It explores the effectiveness of prisons, and the wider criminal justice system, at meeting the healthcare needs of inmates as they leave prison, or transfer between prisons. In doing so, the article details policy context, areas of good practice and issues that still need to be addressed in relation to the creation of an integrated care pathway

A health needs assessment of offenders on probation caseloads in Nottinghamshire and Derbyshire - report of a pilot study

This study was commissioned by the Care Services Improvement Partnership (CSIP) in the East Midlands to investigate the health needs of a sample group offenders managed by The Nottinghamshire and Derbyshire Probation Services

CO3+1 network formation in ultra-high pressure carbonate liquids

Carbonate liquids are an important class of molten salts, not just for industrial applications, but also in geological processes. Carbonates are generally expected to be simple liquids, in terms of ionic interactions between the molecular carbonate anions and metal cations, and therefore relatively structureless compared to more “polymerized” silicate melts. But there is increasing evidence from phase relations, metal solubility, glass spectroscopy and simulations to suggest the emergence of carbonate “networks” at length scales longer than the component molecular anions. The stability of these emergent structures are known to be sensitive to temperature, but are also predicted to be favoured by pressure. This is important as a recent study suggests that subducted surface carbonate may melt near the Earth’s transition zone (~44 km), representing a barrier to the deep carbon cycle depending on the buoyancy and viscosity of these liquids. In this study we demonstrate a major advance in our understanding of carbonate liquids by combining simulations and high pressure measurements on a carbonate glass, (K2CO3-MgCO3) to pressures in excess of 40 GPa, far higher than any previous in situ study. We show the clear formation of extended low-dimensional carbonate networks of close CO32− pairs and the emergence of a “three plus one” local coordination environment, producing an unexpected increase in viscosity with pressure. Although carbonate melts may still be buoyant in the lower mantle, an increased viscosity by at least three orders of magnitude will restrict the upward mobility, possibly resulting in entrainment by the down-going slab

Mental health in Sexual Assault Referral Centres: A survey of forensic physicians

A national survey of Forensic Physicians (FPs) working in Sexual Assault Referral Centres was undertaken. The survey was advertised in the weekly bulletin sent out by the Faculty of Forensic and Legal Medicine. Response was relatively low (n=45). It is estimated that this figures represents about 12% of the workforce. The aim of the survey was to investigate FPs experience of accessing mental health pathways out of a SARC for complainants of all ages. The results concurred with a previous survey of SARC clinical managers with mental health services proving unresponsive. Informed co-commissioning between NHS England and Clinical Commissioning groups can only improve if aspects of complainant's mental health are routinely assessed within SARCs using structured outcome measures. Structured outcomes should be integrated into NHS England's Sexual Assault Referral Centres Indicators of Performance (SARCIP)

Thermal receptivity of free convective flow from a heated vertical surface: linear waves

Numerical techniques are used to study the receptivity to small-amplitude thermal disturbances of the boundary layer flow of air which is induced by a heated vertical flat plate. The fully elliptic nonlinear, time-dependent Navier–Stokes and energy equations are first solved to determine the steady state boundary-layer flow, while a linearised version of the same code is used to determine the stability characteristics. In particular we investigate (i) the ultimate fate of a localised thermal disturbance placed in the region near the leading edge and (ii) the effect of small-scale surface temperature oscillations as means of understanding the stability characteristics of the boundary layer. We show that there is a favoured frequency of excitation for the time-periodic disturbance which maximises the local response in terms of the local rate of heat transfer. However the magnitude of the favoured frequency depends on precisely how far from the leading edge the local response is measured. We also find that the instability is advective in nature and that the response of the boundary layer consists of a starting transient which eventually leaves the computational domain, leaving behind the large-time time-periodic asymptotic state. Our detailed numerical results are compared with those obtained using parallel flow theory

Aspects of the biology and behaviour of Lernaeocera branchialis (Linnaeus, 1767) (Copepoda: Pennellidae)

Lernaeocera branchialis (L., 1767) is a parasitic copepod that parasitises a range of gadoids by anchoring in the proximity of the branchial chamber of its host, deriving nutrition from the blood of its host and causing serious pathogenic effects. This study investigates the taxonomy of the juvenile free-swimming stages and host location behaviour in the pre-metamorphosed adult female. The large size and distinctive appearance of the metamorphosed adult female stage, coupled with the wide exploitation and commercial importance of one of its principle final gadoid hosts, the cod (Gadus morhua L.), means that this species has long been recognised in the scientific literature, and here the extensive literature concerning this potentially important and damaging pathogen is re-examined to provide an up to date overview, which includes both aquaculture and wild fisheries perspectives. Due to disagreements between several descriptions of the L. branchialis juvenile stages, and because the majority of the descriptions are over 60 years old, the juvenile free-swimming stages are re-described, using current terminology and a combination of both light and confocal microscopy. The time of hatching and moults in these stages is also examined. Techniques for the automated creation of taxonomic drawings from confocal images using computer software are investigated and the possibilities and implications of this technique are discussed. The method of host location in L. branchialis is unknown but is likely to involve a variety of mechanisms, possibly including chemo-reception, mechano-reception and the use of physical phenomena in the water column, such as haloclines and thermoclines, to search for fish hosts. In this study the role of host-associated chemical cues in host location by adult female L. branchialis is investigated by analysing the parasites behavioural responses to a range of host-derived cues, in both a choice chamber and a 3D tracking arena. To analyse the data from the experiments, specialised computer software (“Paratrack”) was developed to digitise the paths of the parasites’ movements, and calculate a variety of behavioural parameters, allowing behaviour patterns to be identified and compared. The results show that L. branchialis responds to host-associated chemical cues in a similar way to many copepods in the presence of chemical cues. Of the different cues tested, gadoid conditioned water appears to be most attractive to the parasites, although the wide variation in behavioural responses may indicate that other mechanisms are also required for host location. The different behavioural responses of parasites to whiting (Merlangius merlangus L.) and cod (Gadus morhua) conditioned water, which are both definitive hosts, provide some evidence for sub-speciation in L. branchialis. The role of chemical cues in host location of L. branchialis, and the relative importance of chemical and physical cues in host location are discussed. As well as demonstrating several techniques, which show potential for further development, this work has improved our knowledge of the biology and life-cycle of L. branchialis. Further study of this, and other areas of L. branchialis biology and its host-parasite interactions, should assist the development of contingency plans for the effective management and control of this widespread and potentially devastating pathogen.EThOS - Electronic Theses Online ServiceNERCGBUnited Kingdo

Epidemiology of coinfection with soil transmitted helminths and Plasmodium falciparum among school children in Bumula District in western Kenya.

BACKGROUND: Many school children living in Africa are infected with plasmodia and helminth species and are consequently at risk of coinfection. However, the epidemiology of such coinfection and the implications of coinfection for children's health remain poorly understood. This study describes the epidemiology of Ascaris lumbricoides-Plasmodium and hookworm-Plasmodium coinfection among school children living in western Kenya and investigates the associated risk factors. METHODS: As part of a randomized trial, a baseline cross-sectional survey was conducted among school children aged 5-18 years in 23 schools in Bumula District. Single stool samples were collected to screen for helminth infections using the Kato-Katz technique and malaria parasitaemia was determined from a finger prick blood sample. Demographic and anthropometric data were also collected. RESULTS: Overall, 46.4% of the children were infected with Plasmodium falciparum while 27.6% of the children were infected with at least one soil transmitted helminth (STH) species, with hookworm being the most common (16.8%) followed by A. lumbricoides (15.3%). Overall 14.3% of the children had STH-Plasmodium coinfection, with hookworm-Plasmodium (9.0%) coinfection being the most common. Geographical variation in the prevalence of coinfection occurred between schools. In multivariable logistic regression analysis, hookworm was positively associated with P. falciparum infection. In stratified analysis, hookworm infection was associated with increased odds of P. falciparum infection among both boys (P < 0.001) and girls (P = 0.01), whereas there was no association between A. lumbricoides and P. falciparum. CONCLUSION: These findings demonstrate STH infections are still prevalent, despite the ongoing national deworming programme in Kenya, and that malaria parasitaemia is widespread, such that coinfection occurs among a proportion of children. A subsequent trial will allow us to investigate the implications of coinfection for the risk of clinical malaria

Large Scale Flame Spread Environmental Characterization Testing

Under the Advanced Exploration Systems (AES) Spacecraft Fire Safety Demonstration Project (SFSDP), as a risk mitigation activity in support of the development of a large-scale fire demonstration experiment in microgravity, flame-spread tests were conducted in normal gravity on thin, cellulose-based fuels in a sealed chamber. The primary objective of the tests was to measure pressure rise in a chamber as sample material, burning direction (upward/downward), total heat release, heat release rate, and heat loss mechanisms were varied between tests. A Design of Experiments (DOE) method was imposed to produce an array of tests from a fixed set of constraints and a coupled response model was developed. Supplementary tests were run without experimental design to additionally vary select parameters such as initial chamber pressure. The starting chamber pressure for each test was set below atmospheric to prevent chamber overpressure. Bottom ignition, or upward propagating burns, produced rapid acceleratory turbulent flame spread. Pressure rise in the chamber increases as the amount of fuel burned increases mainly because of the larger amount of heat generation and, to a much smaller extent, due to the increase in gaseous number of moles. Top ignition, or downward propagating burns, produced a steady flame spread with a very small flat flame across the burning edge. Steady-state pressure is achieved during downward flame spread as the pressure rises and plateaus. This indicates that the heat generation by the flame matches the heat loss to surroundings during the longer, slower downward burns. One heat loss mechanism included mounting a heat exchanger directly above the burning sample in the path of the plume to act as a heat sink and more efficiently dissipate the heat due to the combustion event. This proved an effective means for chamber overpressure mitigation for those tests producing the most total heat release and thusly was determined to be a feasible mitigation strategy to incorporate into the microgravity experiment

Collaboration in the design and delivery of a mental health recovery college course: experiences of students and tutors

Background: Recovery Colleges address mental health challenges using an educative approach underpinned by a collaborative recovery orientated philosophy. Research has been limited with no studies identified reporting research on the design and delivery of a specific course.  Aims: To understand how Recovery College students and tutors experience the design and delivery of a mental health Recovery College course, specifically the ‘Building Resilience’ course.  Method: Thematic analysis of qualitative data related to the experience and process of collaboration in recovery college course design and delivery. Data included 13 qualitative individual interviews with course students and tutors and ‘naturally occurring’ data generated through course preparation and delivery.  Results: Findings drew attention to the centrality of: prior experience and design related to students, tutors and the course structure; co-delivery related to tutors and co-learner impacts; and to the course methods and environment.  Conclusions: Commitment to collaboration in design and delivery of Recovery College courses can mobilise the diverse experiences and expertise of tutors and students. The environment and methods of learning have a significant impact and should be considered alongside content. Boundaries between people and areas of knowledge and experience that arise can be viewed as sources of creativity that can enrich courses